In the first Deathsmiles, healing item spawns are based on stage order and destroying specific enemies and objects. The same goes for Deathsmiles II's X mode, but information about these wasn't convenient to find, so here is what I've found!

Unlike Deathsmiles, in II you can tackle the five stages after Field A/Holy Night in any order. Pick Field C/Detritus as your third stage at rank 2 or 3 and kill the second snake that spawns from the bottom of the screen with your lock shot. You'll know the snake is en route when the stone head section starts.

The section is from roughly 1:30 to 1:47 of this video: https://youtu.be/rR9qINNEm7w?t=100

You have two options for a 4th stage cake if you need another heal; Field B/Urban Sprawl and Field D/Haunted Ruins at rank 2 or 3.

Near the end of Field B, kill the large gargoyle with lock shot.

In the middle section of Field D, rank 2 or 3, you'll fight three Crescent Knights before the haunted bookcase section. Kill the second knight that spawns from the left with lock shot.

If you satisfied the TLB requirements (kill all bosses with lock shot, no continues), Satan Claws will drop a cake that recovers two life bars.